Obesity, Hypertension, Social Determinants of Health and the Epidemiologic Transition Among Traditional Amazonian Populations

Background: The health and nutritional situation of adults from three rural vulnerable Amazonian populations are investigated in relation to the Social Determinants of Health (SDH) and the epidemiologic transition.

Aim: To investigate the role of the environment and the SDH on the occurrence of chronic-degenerative diseases in these groups.

Subjects And Methods: Anthropometric, blood pressure and demographic data were collected in adults from the RDS Mamirauá, AM (n = 149), Flona Caxiuanã, PA (n = 148) and quilombolas, PA (n = 351), populations living in a variety of socio-ecological environments in the Brazilian Amazon.

Results: Adjusting for the effect of age, quilombola men are taller (F = 9.85; p < 0.001) and quilombola women present with higher adiposity (F = 20.43; p < 0.001) and are more overweight/obese. Men from Mamirauá present higher adiposity (F = 9.58; p < 0.001). Mamirauá women are taller (F = 5.55; p < 0.01) and have higher values of waist circumference and subscapular/triceps index. Quilombolas present higher prevalence of hypertension in both sexes and there are significant differences in rates of hypertension among the women (χ(2) = 17.45; p < 0.01). The quilombolas are more dependent on government programmes, people from Mamirauá have more economic resources and the group from Caxiunã have the lowest SES.

Conclusion: In these populations, the SDH play a key role in the ontogeny of diseases and the 'diseases of modernity' occur simultaneously with the always present infectoparasitic pathologies, substantially increasing social vulnerability.